Table 1.

Methods for emergency medicine clinicians to contribute to multidisciplinary efforts to prevent strokes in patients with high-risk atrial fibrillation and flutter

Category	Intervention
Discussion and education	Introduce the topic of stroke prevention, stress its importance, and urge continued conversation with an outpatient provider
	Explain the benefits and risks of treatment and nontreatment
	Include personalized stroke-risk information in the discharge instructions
Consultation and shared care	Arrange a follow-up appointment with a primary care provider, cardiologist, or outpatient atrial fibrillation clinic to address stroke prevention
	Consult an available oral anticoagulation service to contact the patient to continue education and, if appropriate, facilitate initiation of anticoagulation. These services are often telephone based and pharmacy led
Pharmacotherapy	Prescribe an appropriate oral anticoagulant medication on discharge (and, if help is needed, consult a cardiologist)
	Adopt a policy of “default short-term anticoagulation therapy” to provide all high-risk patients lacking contraindications a protective tail of stroke prevention for a limited duration until they can follow up in an outpatient setting to decide on a more definitive treatment plan5